Integrative Health Blog

I recently read that about 50% of the pharmaceutical industry’s profits are channeled into marketing and advertising, which explains the bombardment of utterly offensive and misleading media drug ads I am forced to experience when I fail to click the mute button fast enough. But I confess to having cashed in on some of Big Pharma’s, physician-focused marketing efforts, by accepting coffee mugs and other trinkets from drug sales people, and even getting paid to have a free dinner now and then and listen to the latest pharmaceutical pitches. I have even been offered a few six figure research “bribes” in my 35 year career, to “test” the latest drugs on my patients and make sure the outcome data supports the efficacy of the drug. Through the years these research grants were hard to reject when you are struggling to give your kids the best, but I decided my soul would have been forsaken forever if I went down that route, so I have always politely declined such lucrative offers.

I don’t mean to suggest that drugs are not useful. I prescribe them for most of my patients. Drug treatments, like all therapies, should be based on 3 main criteria – safety, efficacy and expense (in that order) – and sometimes drug therapies rise to top of the decision tree. However, drugs are toxins, and since toxicity from plastics, heavy metals, pesticides, preservatives, antibiotic-laced food and many other modern era poisons are common causes of chronic medical and psychiatric problems, one might wonder why the prescribing of potentially toxic pharmaceuticals, which could worsen ones total toxic load, is not done with far more discretion.

In my opinion, the foremost indication for prescribing a drug is to kill infectious organisms (like fungus or parasites) or certain cancers, conditions which are usually far more toxic than the drugs used to treat them. Also drugs are useful for toxin removal, such as chelating away heavy metals like lead with the drug EDTA. Temporarily worsening the “toxic load” with poisonous, prescribed chemicals, in order to safely detoxify my patients from far worse toxic problems is often a fair and necessary trade off.

An extremist position, sometimes echoed by some alternative practitioners, that no place for drug therapies exists at all in healing, is in my opinion as dangerous as out-of-control prescribing practices in conventional healthcare. To withhold drugs when they can be healing and life saving is unconscionable. However I am sympathetic to the naturopath’s concerns about drug therapies, because some conventional doctors may not be prescribing with the discretion I alluded to above.

Peer-reviewed, published articles have suggested that drug reactions, due to drugs which were prescribed according to “accepted standards of care” (no mistakes in treatment), are the third leading cause of death behind heart disease and cancer (see Barbara Starfield, MD, MPH, Is US Health Really the Best in the World? JAMA. 2000; 284: 483-485). In fact, any licensed physician who does not prescribe drugs according to such “accepted standards of care” can open themselves up to criticism by regulators and their patients. I am sympathetic to the regulatory and economic pressures which doctors must contend with, to prescribe out of fear of such repercussions, and their need to pay exorbitant malpractice insurance rates because they are compelled to harm some patients in their careers by conforming to Big Pharma’s “accepted standards of care.”

US Healthcare was ranked 37th in the world[1], despite the fact that the US spends more per capita on healthcare than any country. The root of the so-called “health care crisis” in the US is defined by the fact that non-pharmacological and non-surgical healing therapies and alternative medicine is generally accepted and welcomed everywhere else in the world. Drug therapies are expensive and potentially dangerous. Modifying symptoms with toxic chemicals without getting to the root causes of chronic medical and psychiatric problems simply “kicks the can down the road” for far worse problems. How do we solve this dilemma? How can a truly integrated model of healthcare evolve in the US which includes both the judicious use of drug therapies and alternative therapies? How can we solve the “health care crisis” by creating a delivery system which is safer, more efficacious and far less expensive?

The solution, in my opinion, lies in understanding how Big Pharma came to dominate US healthcare in the first place. The answer is simple – the science of pharmacology is exactly that, a science. While most of us who provide non-conventional treatments for our patients believe that much of alternative and integrative medicine is effective, a great deal of research has yet to be done to determine what is valid. This void of research findings allows Big Pharma to take the scientific high ground, dismiss all other competitive therapies as witchcraft and snake oil and then on this scientific footing, dictate to the medical profession, the politicians and the regulators what the accepted standard of care shall be. Until this simple issue is confronted, I cannot foresee how a new standard of care which merges integrative and alternative medicine with conventional medicine can evolve.

Since the strength of Big Pharma is science, how will integrative medicine capture its own scientific turf? This is where functionalmedicine and predictive genomics[2] shines. Instead of simply medicating the symptoms of chronic medical or psychiatric problems with drugs, why not practice at a higher, more science-based, standard of care and diagnose the causes of maladies, by testing for nutritional deficiencies, toxicities, food allergies, gastrointestinal problems, hormone and neurotransmitter imbalances, metabolic abnormalities and the genetic vulnerabilities to all of that? At the very least we can now diagnose which patients are likely to have detoxification problems with certain classes of drugs and greatly lower morbidity and mortality statistics. Simply put, if you don’t test you’ve guessed!

Only through functional medicine and genomics can integrative medicine practitioners capture the higher scientific ground now occupied by pharmaceutical-based healthcare. Only through functional medicine and genomics can integrative medicine gain the scientific clout to influence public policies and eventually mold US healthcare into a safer, more efficacious and less expensive delivery system. Functional medicine and genomics will also open the door to much needed research required to validate energy medicine and other integrative medicine therapies. However, even though functional medicine and genomics will eventually render most drug therapies obsolete, drugs will always be needed to treat many infectious and toxicity-related problems, as well as many acute and end-stage health conditions. A truly integrative healthcare system will someday evolve which integrates all approaches, alternative, conventional and functional medicine and predictive genomics.